Republicans who now have the power to deliver on their central promise of the past seven years — repealing Obamacare and replacing it with a market-based alternative — are facing a gut-check moment. As they fear the potential political backlash, they must ask themselves: Do Republicans love freedom as much as Democrats love big government?

Democrats took a big risk to expand the role of government in healthcare. During the 13-month process that produced Obamacare, there were many freak out moments. There were missed deadlines, scary Congressional Budget Office numbers, terrible polling, and constant infighting among liberals and more centrist members of the party. There were many times when it looked like it could all fall apart and where there was real reason to fear their majorities could be at risk — the massive, nationwide protests and uprisings at town hall meetings, and even the defeat of a Democratic Senate candidate in the deep blue state of Massachusetts in a special election to replace the liberal lion, and champion of national healthcare, Ted Kennedy. And there were voices in Congress, in the media, and in the White House — right up to Chief of Staff Rahm Emanuel — arguing that Democrats needed to cut their losses and scale back their ambitions.

But Democrats persevered. Ultimately, amid their differences, they saw a once in a lifetime opportunity to make progress toward the dream of universal health coverage that had eluded them for more than a half a century. Their leaders, from President Obama, to Speaker Nancy Pelosi, and even Senate Majority Leader Harry Reid, kept the pressure on, twisted arms, cajoled, and communicated at every opportunity that inaction was not an option. Dozens of Democrats ultimately cast votes in favor of a bill that they knew was more likely than not to mean the end of their political careers. And they were right. More than any other factor, Obamacare contributed to the staggering losses Democrats faced in the House and the Senate. But in the end, they left behind the legacy of Obamacare. Viewed one way, Democrats defied the will of the people to ram through a massive overhaul of the nation’s healthcare system on purely partisan terms. Viewed another way, they were willing to risk political defeat to deliver on something they believed in.

So, do Republicans believe anything they’ve been saying? Do they think Obamacare is an abomination, that kills jobs, drives up costs, erodes the quality of coverage, and stifles innovation? Do they believe Obamacare needs to be repealed and replaced, as they have insisted in every campaign they have run since 2010? If they do, they have a duty to follow through on the promises to which they owe their majorities, no matter the political risks.

I am in no way ignorant of the potential political backlash that could come from repeal and the difficulties of getting Republicans to agree on a replacement. In fact, for years, I have been urging Republicans to start developing a plan precisely to prepare for the moment that has now come — I even wrote a book on the subject.

But without being sanguine about the political risks of repeal, Republicans need to also consider the backlash that will inevitably come if they do not. To start, Obamacare cannot survive as it is. It is simply not a sustainable system. Insurers are not enrolling enough young and healthy individuals to offset the cost of covering older and sicker enrollees. They keep raising premiums, and supporters of the law claim that the plans are now priced appropriately, but then claims come in, and it turns out that they are not and that insurers are still losing money.

Humana has said it would be pulling out of the market completely for 2018. And the experience of Molina Healthcare is even more telling. Molina was a relatively small insurer that had invested heavily in Obamacare. It was one of the insurers that was highly touted by the law’s supporters as a real success story. A sample of the headlines in the past year or so: “Molina Healthcare Thriving Under Obamacare”; “Molina Outperforms Rivals in ACA Marketplaces”; and “Meet the insurer making money from ObamaCare.” But in actuality, the insurer reported that they lost $110 million on the exchanges last year, performance that was “substantially” lower than expected, and could no longer commit to the program in 2018. And, lest liberals chime in that this was due to the uncertainty caused by repeal efforts and President Trump cutting Obamacare ads in the final days of January, it should be noted that those results were from 2016, when Obama was still in power and using the full weight of the executive branch to prop up his signature legislation. If Republicans do nothing, market chaos will ensue anyway, and they’ll face political consequences.

Another strategy that Republicans seem to be seriously contemplating is one that I’ve called Repeal In Name Only. This is a strategy in which Republicans tinker around the edges, add some free market window dressing (a little health savings account expansion here, a bit of increased state flexibility there) and yet, they preserve much of the spending of Obamacare as well as leave the Medicaid expansion largely intact. If Republicans pursued this strategy, they would no doubt try to argue, out of one side of their mouths, that people won’t be losing their Obamacare coverage, and then with the other, tell conservatives that they delivered on their promises, and then they with cross their fingers and hope and pray that voters are too dumb to tell the difference. The reality is that doing some tinkering while keeping much of Obamacare intact will ensure the worst of all worlds. Conservatives will realize that they’ve been had, and that Republicans pulled off what may be the biggest broken promise in American political history. So their own base will be dispirited in 2018, when the incumbent party typically loses seats. Meanwhile, because Republicans would be trying hard to convince the public that they actually did do something, Democrats could blame Republicans for any problems with the healthcare system.

Republicans actually have a one-time opportunity to do what they’ve long promised — which is to fully repeal Obamacare, with all its taxes, and spending, and regulatory overreach — and to replace it with a market-based system that provides more choices, lowers costs, and puts patients in charge of their own healthcare. If they get this done, even if they lose their majorities, it will have been worth it. They can say that when they had power, they used it to advance something they believed in and made a real difference. If they flub this, then we know what will happen. Democrats will eventually take power again, and they’ll have much of the foundation of Obamacare left to build on. They will add subsidies and regulations, and perhaps an additional government-run plan, and the nation will be further on its way to single-payer.

Also from the Washington Examiner

The House Intelligence Committee on Tuesday plans to release a statement defining the scope of its “full blown” investigation into Russian hacking prior to the 2016 elections, including whether there were contacts between the Trump campaign and any Russian officials.

“We will have a statement we will put out on that today,” said House Intelligence Committee Chairman Devin Nunes, R-Calif., adding a public report will likely follow.

Nunes and other Republican leaders on Tuesday repeated their belief that there is, so far, no evidence of any contact between Russia and officials who worked on the campaign of president.

House Speaker Paul Ryan, R-Wis., told reporters Tuesday, “We had seen no evidence so far based upon the

•

02/28/17 11:19 AM

Americans are in a long-term struggle over the scale of control that government is going to exert over their lives. The side that wants to limit government has been getting beaten badly, because the side that wants to expand government is willing to take more political risks than the side that purports to support freedom and less government. If Democrats take ten steps forward when they’re in power, and Republicans merely pull them back a step when they assume power, then Americans and their state governments will be forced to cede more and more power to Washington until the U.S. is indistinguishable from a European social welfare state.